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CAPNOCYTOPHAGA CANIMORSUS ENDOPHTHALMITIS AFTER CATARACT SURGERY LINKED TO SALIVARY DOG-TO-HUMAN TRANSMISSION.

CAPNOCYTOPHAGA CANIMORSUS ENDOPHTHALMITIS AFTER CATARACT SURGERY LINKED TO SALIVARY DOG-TO-HUMAN TRANSMISSION.
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Thommen F, Opota O, Greub G, Jaton K, Guex-Crosier Y, Wolfensberger TJ, Matet A,


Thommen F, Opota O, Greub G, Jaton K, Guex-Crosier Y, Wolfensberger TJ, Matet A, (click to view)

Thommen F, Opota O, Greub G, Jaton K, Guex-Crosier Y, Wolfensberger TJ, Matet A,

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Retinal cases & brief reports 2017 09 27() doi 10.1097/ICB.0000000000000637
Abstract
PURPOSE
To describe a case of acute postoperative bacterial endophthalmitis because of Capnocytophaga canimorsus after cataract surgery, with probable contamination through salivary droplets of dog two days after the procedure.

METHODS
An 83-year-old woman who underwent uncomplicated cataract extraction with intraocular lens implantation, presented 12 days later with acute pain, redness, and vision loss in her left eye. Visual acuity was hand motion and clinical findings suggested the diagnosis of acute postoperative endophthalmitis. The patient underwent diagnostic vitrectomy, intravitreal ceftazidime/vancomycin injection and received oral moxifloxacin (400 mg/day). Two days later, she underwent complete pars-plana vitrectomy because of the absence of clinical improvement. Vitreous samples showed gram-negative bacterium on direct examination but cultures remained sterile, which prompted the realization of a broad-range bacterial polymerase chain reaction analysis.

RESULTS
Polymerase chain reaction on the vitreous sample detected C. canimorsus, a fastidious gram-negative bacterium of the oral canine flora. When asked for recent contact with dogs, the patient reported having proceeded to an intensive tooth care session for her dog at postoperative Day 2. Intravenous ceftriaxone (2 g/day) was added to the treatment. Anterior and posterior segment inflammation slowly resolved, and final visual acuity was 20/160.

CONCLUSION
Although very rare, this complication suggests that patients undergoing ocular surgery should avoid contact with salivary secretions of pets during the early postoperative period. Diagnostic broad-range bacterial polymerase chain reaction is useful to detect unconventional or slow-growing agents in vitreous samples.

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